Chapter 07: Health Promotion and the Family

Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE
1. A nurse is determining which family assessment tool would be best to implement with a

family when planning home visits for health promotion. Which of the following criteria
should the nurse use to evaluate these tools?
a. The number of questions asked on the assessment tool
b. The linkages of the assessment to Healthy People 2020
c. The amount of involvement that the family has in completing the tool
d. The capability of the tool to assess goals and outcomes
ANS: C

Useful health-promotion family assessments involve listening to families, engaging in

participatory dialogue, recognizing patterns, and assessing family potential for active, positive
change.
DIF: Cognitive Level: Apply (Application)

REF: pp. 150-151

2. Which of the following best describes the nurses role in health promotion and disease

prevention?
a. Educating about home safety measures
b. Identifying areas for family improvement
c. Implementing the nursing process using a systems perspective
d. Acting as a role model for the family
ANS: D

The nurses role in health promotion and disease prevention is best described as acting as a
role model for the family. Implementing the nursing process, identifying areas for family
improvement, and educating about home safety measures are all part of the nurses role but do
not describe the comprehensive role of the nurse.
DIF: Cognitive Level: Remember (Knowledge)

REF: pp. 151-152

3. Which of the following theories is an attempt to explain families as a set of interacting

individuals with patterns of living that influence health decisions?

Feminist theory
Systems theory
Developmental theory
Resiliency theory

a.
b.
c.
d.

ANS: B

Systems theory is an attempt to explain patterns of living among the individuals who make up
the family system.
DIF: Cognitive Level: Remember (Knowledge)

REF: p. 151

4. A nurse is assessing how a family will transition and adapt after their youngest child leaves

for college. By using this framework, which of the following perspectives is the nurse
implementing?
a. Risk-factor
b. Structural-functional
c. Open systems
d. Developmental
ANS: D

Duvall and Miller identified stages of the family life cycle and critical family developmental
tasks, through a developmental perspective. This conceptual model helps to anticipate family
events and discusses how families complete basic family tasks as they transition through these
events.
DIF: Cognitive Level: Apply (Application)

REF: p. 152

5. Which of the following would be described as a family structural component?

a. Income earner of the house
b. Socialization for the family
c. Immunization of infants
d. Launching of children
ANS: A

Structural components of the family refer to family roles and relationships.

DIF: Cognitive Level: Apply (Application)

REF: p. 152

6. A nurse is collecting data for a family assessment using Gordons functional health patterns.

The nurse learns that the family has no books in the home to read to the preschool-age
children. To which of the following functional health patterns does this information pertain?
a. Roles-relationship
b. Cognitive-perceptual
c. Health-perceptionhealth-management
d. Self-perceptionself-concept
ANS: B

The cognitive-perceptual pattern identified characteristics of language, cognitive skills, and

perception that influence desired or required family activities. The availability of books in the
home for preschool age children impacts this functional health pattern.
DIF: Cognitive Level: Analyze (Analysis)

REF: p. 157

7. A nurse who is using Gordons functional health patterns is planning to assess its roles-

relationships pattern. Which of the following questions would be most appropriate for the
nurse to ask?
a. What is the familys philosophy of health?
b. What does the family do to have fun?
c. How are problems in the family resolved?
d. Who decides when and how children go to sleep?
ANS: C

How problems in the family are resolved relates to assessment of the roles-relationships
pattern. The familys philosophy of health relates to the health perception-health management
pattern. What the family does to have fun relates to the activity-exercise pattern. The decision
concerning when and how children go to sleep relates to the sleep-rest pattern.
DIF: Cognitive Level: Analyze (Analysis)

REF: pp. 158-159

8. A nurse is using a genogram to represent a family. Which of the following statements is

accurate?
A genogram identifies the genetic disorders of the family.
A genogram includes information about the past two generations.
A genogram can be used to make connections about family health patterns.
A genogram begins with a circle in the center of the page.

a.
b.
c.
d.

ANS: C

A genogram shows a variety of family structures and highlights family health patterns, which
can be used for anticipatory health guidance. Significant diseases and disorders of the family
members are highlighted on the genogram. Data on at least three generations are reported on a
genogram. The genogram uses a variety of symbols to demonstrate connections but does not
begin with a circle in the center of the page.
DIF: Cognitive Level: Apply (Application)

REF: p. 160

9. The ecomap of a clients family has slashed lines drawn from the son to the family church.

Based on this information, what conclusion can the nurse make?

The son is deceased.
The son is actively involved with the family church.
The son has a stressful relationship with the church.
The son has no relationship with the church.

a.
b.
c.
d.

ANS: C

Slashed lines on an ecomap signify stressful relationships.

DIF: Cognitive Level: Apply (Application)

REF: p. 160

10. A client reports that her family will be moving because her husband is taking a new job in

another state. She is very unhappy about the decision and doesnt want to move. What action
should the nurse take next?
a. Assess the clients and familys coping mechanisms in handling stress.
b. Encourage the client to act excited about the move.
c. Talk to the husband to get his perspective on the move.
d. Tell her that all families must cope with new situations from time to time.
ANS: A

The familys ability to cope with demands of everyday living determines its level of success.
The nurse needs to assess how the family usually copes with stressful situations to find ways
that might be available to the family now to cope with the current situation.
DIF: Cognitive Level: Analyze (Analysis)

REF: p. 164

11. In a family in which the mother and the father differ on how to spend and save money, the

parents are constantly arguing with each other. Which of the following interventions should
the nurse include in the plan of care for this couple?
a. Assist them to develop strategies that are congruent with their values.
b. Allow each of them to defend his or her own values.
c. Focus on outcomes that each wants to accomplish.
d. Divert their attention to areas in which they are successful.
ANS: A

When strategies are used that are congruent with each individuals values, the couple adjusts.
DIF: Cognitive Level: Apply (Application)

REF: p. 166

12. A blended family has six children, ages 2, 4, 4, 5, 7, and 10. During a visit to the home, the

nurse notices that the 7-year-old seems quiet and withdrawn, whereas the other children are
playing loudly in the garage. Which of the following conclusions can the nurse make from this
observation?
a. This child has most likely been abused.
b. This child is one of multiple children closely spaced in age.
c. This family suffers from low self-esteem.
d. This family provides harsh punishment for their children.
ANS: B

Risks associated with role relationships in blended families include multiple closely spaced
children, which limits the parents time for interaction to meet individual childrens needs.
DIF: Cognitive Level: Apply (Application)

REF: p. 167

13. The nurse is caring for a family who has 2-year-old twins. Which of the following health

promotion advice would be included in the nurses plan of care for this couple?
Wear bicycle helmets for safety.
Use caution around the family swimming pool.
Cross the street at using the crosswalks.
Advocate for the day care to provide adequate socialization.

a.
b.
c.
d.

ANS: B

Two-year-olds are prone to wandering to where water is and could fall into a swimming pool
without being noticed.
DIF: Cognitive Level: Apply (Application)

REF: p. 167

14. A nurse is conducting a health promotion assessment for a family with a 9-month-old. Which

of the following should be of most concern to the nurse?

The age of the house in which the family lives
Genetic diseases in the family
Driving practices in the family
Toilet training for the child

a.
b.
c.
d.

ANS: A

A typical 9-month-old is beginning to crawl. Houses built before 1974 may contain lead-based
paint, to which a crawling baby might have access. Lead causes neurological damage and
anemia.

DIF: Cognitive Level: Analyze (Analysis)

REF: p. 167

15. A nurse is caring for a family with an adolescent child. Which of the following problems

would the nurse anticipate that the family would report?

Concerns about career decisions
Concerns about exposure to environmental hazards
Difficulty with parents finding fulfillment with raising the child
Difficulty with open communication with the child

a.
b.
c.
d.

ANS: D

Open communication with parents is often difficult during the adolescent stage, partly because
of the differing developmental tasks of adolescents and adults. Concerns about exposure to
environmental hazards and parents finding fulfillment with raising the child typically are
concerns with families with younger children. Concerns about career decisions are typically
problematic for families with older children/young adults.
DIF: Cognitive Level: Apply (Application)

REF: p. 168

16. The nurse is working with a middle-age married couple whose son has just graduated from

college. Which developmental tasks would the nurse expect to find in this family?
Attending activities for their son
Strengthening their marital relationship for future family stages
Acting as a launching center for their son
Responding to the prospect of changing careers

a.
b.
c.
d.

ANS: C

Families with young adults act as launching centers for children ready to leave home.
DIF: Cognitive Level: Apply (Application)

REF: pp. 168-169

17. A nurse has developed a family nursing diagnosis. Which of the following best describes the

purpose of this action?

Describes the strengths of the family
Allows for creation of goals for the family
Promotes behavioral change among family members
Validates health problems with the family

a.
b.
c.
d.

ANS: D

Writing a family nursing diagnosis helps families promote health throughout the life cycle and
prevents disease through decreasing risk-taking behaviors. Nurses derive diagnoses from
assessed validated data. The nursing diagnosis describes and validates potential or actual
health problems with families. The diagnosis provides direction for outcomes and
interventions first identifying what the problem is.
DIF: Cognitive Level: Apply (Application)

REF: p. 170

18. A home care nurse is planning an intervention with a family focusing on decreasing

susceptibility. Which of the following nursing interventions would be most appropriate to

implement?
a. Education about building on current strengths of the family
b. Education about hand hygiene

c. Education about health care resources in the community

d. Education about child safety seats
ANS: B

Four types of nursing interventions appear in health-promotion and disease-prevention

planning: increasing knowledge and skills; increasing strengths; decreasing exposure; and
decreasing susceptibility. Decreasing susceptibility means educating families about prevention
principles. Examples include education about hand hygiene and how diseases are spread from
person to person and by other factors in the environment.
DIF: Cognitive Level: Analyze (Analysis)

REF: p. 171

19. A nurse is making a final home visit with a family to evaluate the nursing care plan. Which of

the following actions would the nurse most likely complete during this visit?
Obtain vital signs from all members of the family.
Ask the family members to state the goals that were previously developed.
Collect data similar to that which was collected at the initial visit for comparison.
Educate about the importance of using role relationships to create a healthy family.

a.
b.
c.
d.

ANS: C

The purpose of evaluation is to determine how the family has responded to the planned
interventions and whether these interventions were successful. The familys baseline data are
used as comparative criteria in evaluation; thus, it would be worthwhile to collect data similar
to that collected at the initial visit to see if any changes have occurred. The nurse reassesses
the situation and compares the new information with that on the original assessment to
determine whether change has occurred.
DIF: Cognitive Level: Analyze (Analysis)

REF: p. 172

20. A nurse is planning a home visit for a family. Which of the following actions would be most

appropriate for the nurse to take?

Study information regarding the family from agency records and other sources.
Make a contract with the family that states specific goals and objectives.
Identify how the home visit will be financed.
Understand the situation from the familys perspective.

a.
b.
c.
d.

ANS: A

Part of planning the home visit is studying information regarding the family from agency
records, referral forms, and other sources. Making a contract, identifying how the visit will be
financed, and understanding the situation from the familys perspective are all part of the
process of making the visit.
DIF: Cognitive Level: Apply (Application)

REF: p. 151 (Box 7-1)

21. A nurse is providing follow-up care for a family who has recently had a baby. Which of the

following topics should the nurse anticipate discussing with the family?
Type 1 diabetes
Fetal alcohol syndrome
Communicable diseases
SIDS

a.
b.
c.
d.

ANS: D

Families in the beginning childbearing stage need education about the risk of SIDS for their
infant. After the birth of the child, it is most likely that they do not need education about fetal
alcohol syndrome, unless there were issues with alcohol use during the prenatal period.
Discussion about communicable diseases and potentially Type 1 diabetes would be more
common with families with school-aged children.
DIF: Cognitive Level: Apply (Application)

REF: p. 154 (Table 7-1)

MULTIPLE RESPONSE
1. A home health nurse is admitting a 54-year-old man for services following a coronary artery

bypass graft (CABG). As part of the initial visit the nurse completes a family assessment.
What is the purpose of this nursing action? (select all that apply)
a. Allows for health promotion and disease prevention appraisal
b. Allows for inclusion of family members in decision-making
c. Allows for data collection necessary for comparison to Healthy People 2020
d. Allows for development of patient-centered care
ANS: A, B

Families provide the structure for many health promotion practices; therefore, family
assessment informs health promotion and disease prevention appraisal. Additionally, health
providers are encouraged to include families in decision-making and encouraging their
presence and participation in all aspects of care from acute care to health promotion. Thus, it
is important to have assessed the family so that the family can be included in the care process.
DIF: Cognitive Level: Apply (Application)

REF: p. 150

2. A nurse is providing care for a family in the community. Which of the following

characteristics would the nurse assess to determine the health of the family? (select all that
apply)
a. Developmental stage of each family member
b. Coping mechanisms of each family member
c. Potential risk factors within the family
d. Maintenance of trust within the family
ANS: B, C, D

Coping mechanisms of each family member, potential risk factors within the family, and
maintenance of trust within the family are all necessary characteristics for the nurse to assess
when determining the health of a family. When assessing a family, the nurse will consider the
developmental stage of the family before considering the developmental stage of each of the
individual family members.
DIF: Cognitive Level: Apply (Application)

REF: p. 152 (Box 7-2)

3. A nurse is conducting an environmental assessment as part of a family assessment. Which of

the following would the nurse assess? (select all that apply)
Garbage collection in the neighborhood
Convenience stores in the neighborhood
Safety of the home
Climate of the home

a.
b.
c.
d.

ANS: A, B, C, D

The family environment is made up of the home, neighborhood, and community. Thus,
aspects of the community as well as aspects of the home environment need to be analyzed
during this assessment.
DIF: Cognitive Level: Apply (Application)

REF: p. 165